1. The incidence of coronary heart disease is gradually increasing
. The standard of living is improving, the diet structure is changing → cardiovascular morbidity is increasing, and the mortality rate may exceed that of malignant tumors to become the first.
Coronary heart disease is a “disease of affluence”.
. Coronary heart disease treatment methods: medication, interventional (PTCA and stenting, etc.) and surgical coronary artery bypass surgery. 2.
2. what is coronary artery bypass surgery
. Coronary artery bypass surgery is a procedure in which a blood vessel is removed from the patient’s own body and sutured at one end to the distal end of a narrowed coronary artery and at the other end to the aorta. Blood is passed from the aorta to the distal end of the blocked coronary artery through the bridge that has been built.
. The vessels used for bridging: internal mammary artery, saphenous vein, radial artery, etc., with the internal mammary artery having the best results
3. Who needs coronary artery bypass surgery
. Patients with angina pectoris, such as those with stable angina pectoris that has failed medical treatment and significantly affected their ability to work or live, those with unstable angina pectoris that has failed medical treatment, or those with variant angina pectoris with moderate to severe coronary artery obstruction that has failed medical treatment, or those with post-infarction angina pectoris, should undergo surgical bypass surgery if the above patients have significant stenosis or obstruction in the left main or multiple vessels as confirmed by angiography.
. It is generally accepted that coronary artery angiography should be performed if the left main stem stenosis and obstruction are >50%, or if the left anterior descending branch stenosis and obstruction are >50%, and if percutaneous transluminal coronary angioplasty (PTCA) is not suitable, or if there are three or more branches with obvious symptoms.
. For acute heart attack: Emergency “bypass” within 6 hours after the heart attack. If the infarction has exceeded 6 hours, the surgery should be performed after 1 month of medical treatment.
. For post-acute infarction complications: left ventricular wall tumor, septal perforation, papillary muscle rupture, ventricular rupture, and post-infarction cardiogenic shock that cannot be controlled by medical treatment, emergency surgery should be performed.
. Secondary bypass surgery
4. Problems that need attention after coronary artery disease surgery
. The first is medication: anticoagulant drugs for life, other lipid-lowering drugs, heart rate control drugs, blood pressure lowering drugs, etc. as prescribed by the doctor.
. The second is diet, which usually requires an increased intake of calories, protein and vitamins to promote a speedy recovery after surgery. Pay attention to control hyperlipidemia and hyperglycemia.
. The third is exercise. Early postoperative activity in bed is required to reduce postoperative complications. Gradually increase the amount of activity, indoor exercise → outdoor exercise, gradually increase, in the process of exercise and exercise, if chest pain, shortness of breath, asthma and fatigue, etc., should be stopped immediately.
. The fourth is work. It is completely possible to return to normal work, and after four weeks to six weeks of discharge, you can discuss with your doctor about returning to work.
5. Safety of coronary artery bypass surgery
. Coronary artery bypass surgery has become a routine procedure in cardiac surgery after decades of development, and the safety of the procedure is very high
. The success rate of the procedure in many large centers in China and abroad is over 98% and 99%.
. Patients who require surgery, especially for left main stem lesions, may be at greater risk without surgery.